Postdoctoral Researcher, Health Economics Unit, Department of Clinical Sciences (Malmö), Lund University, Sweden.
Associate Professor, Health Economics Unit, Department of Clinical Sciences (Malmö), Lund University, Sweden.
Br J Psychiatry. 2020 Apr;216(4):197-203. doi: 10.1192/bjp.2018.247.
A randomised controlled trial found that a structured mindfulness group therapy (MGT) programme was as effective as treatment as usual (mostly cognitive-behavioural therapy) for patients with a diagnosis of depression, anxiety or stress and adjustment disorders in Sweden (ClinicalTrials.gov: NCT01476371).
To perform a cost-effectiveness analysis of MGT compared with treatment as usual from both a healthcare and a societal perspective for the trial duration (8 weeks).
The costs from a healthcare perspective included treatment as usual, medication and costs for providing MGT. The societal perspective included costs from the healthcare perspective plus savings from productivity gains for the trial duration. The effectiveness was measured as quality-adjusted life-years (QALY) using the EQ-5D-5L questionnaire and the UK value set. Uncertainty surrounding the incremental costs and effects were estimated using non-parametric bootstrapping with 5000 replications and presented with 95% confidence intervals and cost-effectiveness acceptability curves.
The MGT group had significantly lower healthcare and societal costs (mean differences -€115 (95% CI -193 to -36) and -€112 (95% CI -207 to -17), respectively) compared with the control group. In terms of effectiveness, there was no significant difference in QALY gain (mean difference -0.003, 95% CI -0.0076 to 0.0012) between the two groups.
MGT is a cost-saving alternative to treatment as usual over the trial duration from both a healthcare and a societal perspective for patients with a diagnosis of depression, anxiety or stress and adjustment disorders in Sweden.
一项随机对照试验发现，在瑞典，结构化正念团体治疗（MGT）方案与常规治疗（主要是认知行为疗法）对抑郁症、焦虑症或压力和适应障碍患者的疗效相当（ClinicalTrials.gov：NCT01476371）。
从医疗保健和社会两个角度，对 MGT 与常规治疗进行成本效益分析，分析时间为试验持续时间（8 周）。
从医疗保健角度来看，成本包括常规治疗、药物治疗和提供 MGT 的费用。从社会角度来看，成本包括医疗保健角度的成本加上试验持续时间内因生产力提高而节省的成本。使用 EQ-5D-5L 问卷和英国价值集来衡量有效性，以质量调整生命年（QALY）表示。使用非参数自举法（5000 次重复）估计增量成本和效果的不确定性，并以 95%置信区间和成本效益可接受性曲线表示。
MGT 组的医疗保健和社会成本明显低于对照组（平均差异-€115（95%CI-193 至-36）和-€112（95%CI-207 至-17））。在有效性方面，两组之间 QALY 增益没有显著差异（平均差异-0.003，95%CI-0.0076 至 0.0012）。
在瑞典，对于抑郁症、焦虑症或压力和适应障碍患者，MGT 是常规治疗的一种具有成本效益的替代方案，从医疗保健和社会两个角度来看，在试验持续时间内都可以节省成本。
